CN104936545B - System and method for designing intervention programs - Google Patents

System and method for designing intervention programs Download PDF

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Publication number
CN104936545B
CN104936545B CN201380068398.6A CN201380068398A CN104936545B CN 104936545 B CN104936545 B CN 104936545B CN 201380068398 A CN201380068398 A CN 201380068398A CN 104936545 B CN104936545 B CN 104936545B
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plurality
interventional
position
optionally
channels
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CN201380068398.6A
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Chinese (zh)
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CN104936545A (en
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C·Q·登霍欧
P·乔普拉
C·赖利
T·赵
D·潘埃斯库
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直观外科手术操作公司
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Priority to US61/747,920 priority
Priority to US14/144,232 priority patent/US20140188440A1/en
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Priority to PCT/US2013/078508 priority patent/WO2014106253A1/en
Publication of CN104936545A publication Critical patent/CN104936545A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/04Endoscopic instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/0841Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/085Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4245Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4263Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors not mounted on the probe, e.g. mounted on an external reference frame
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101Computer-aided simulation of surgical operations
    • A61B2034/102Modelling of surgical devices, implants or prosthesis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107Visualisation of planned trajectories or target regions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2051Electromagnetic tracking systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364Correlation of different images or relation of image positions in respect to the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/0059Detecting, measuring or recording for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0062Arrangements for scanning
    • A61B5/0066Optical coherence imaging
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/06Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/065Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4245Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient

Abstract

设计布置介入器械的程序的方法包括接收解剖学结构的模型。 Interventional instrument design program includes receiving arrangement model anatomy. 该解剖学结构包括多个通道。 The anatomical structure comprises a plurality of channels. 该方法进步包括在模型中鉴定目标结构,和接收关于介入器械在多个通道内的操作能力的信息。 The method comprises identifying a target progress in the model structure, and the ability to receive information regarding the operation of the interventional instrument within the plurality of channels. 该方法进步包括基于介入器械操作能力鉴定用于定位介入器械远端以对目标结构执行程序的设计布置位置。 The method includes progress-based interventional device to identify operational capability for positioning the distal end of the interventional device in order to design the arrangement position of the target program structure executed.

Description

设计介入程序的系统和方法发明领域 FIELD OF THE INVENTION Systems and interventional procedures designed

[0001 ]本公开涉及穿过患者解剖结构实施微创程序的系统和方法,更具体地涉及设计布置介入器械的程序的系统和方法。 [0001] The present disclosure relates to a system and method for passing through the patient's anatomy embodiment of minimally invasive procedures, and more particularly relates to systems and methods for design and layout process the interventional instrument.

[0002] 发明背景 [0002] Background of the Invention

[0003] 微创医疗技术意图减少介入程序过程中损伤的组织量,从而减少患者恢复时间、 不适和有害副作用。 [0003] minimally invasive medical technologies intention to reduce the amount of tissue damage during interventional procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects. 这种微创技术可通过患者解剖学的自然孔口或通过一个或多个外科切口进行。 This minimally invasive technique may be performed by one or more surgical incision through the patient's anatomy or natural orifice. 通过这些自然孔口或切口,临床医生可插入介入器械(包括外科、诊断、治疗、或活组织检查器械)到达目标组织位置。 These natural orifice or incision, a clinician can insert the interventional instrument (including surgical, diagnostic, therapeutic, or biopsy instrument) reaches the target tissue site. 为到达目标组织位置,微创介入器械可穿过解剖学系统如肺、结肠、肠、肾、心脏、循环系统、或类似物中的自然或外科生成的通道。 To reach the target tissue site, minimally invasive instrument can be passed through anatomical systems, such as lung, colon, intestine, kidney, heart, circulatory system, or the like generated naturally or surgical channel. 为协助临床医生使器械穿过通道,利用术前或操作间成像来制备通道的模型。 To assist the clinician so that the instrument through the channel, the channel model can be prepared by using or operating room preoperative imaging. 当前用于布置介入器械的系统将器械布置位置鉴定为模拟通道中最接近目标组织位置的点。 The instrument is arranged to identify the current position of the interventional instrument arrangement system for analog channels for the point closest to the target tissue location. 鉴于介入器械或解剖结构的限制,这种最接近点布置位置可能难以到达。 Given the limitations of the interventional device or anatomy, such a position closest point arrangement may be difficult to reach. 需要改进的系统和方法来确定用于对目标组织位置实施程序的设计器械布置位置。 Need for improved systems and methods for designing the instrument to determine the position of arrangement of the embodiment of the program targeted tissue site.

[0004] 发明概述 [0004] Summary of the Invention

[0005] 所附权利要求概括了本发明的实施方式。 [0005] Embodiments of the invention summarized in the appended claims.

[0006] 在一个实施方式中,设计布置介入器械的程序的方法包括接收解剖学结构的模型。 [0006] In one embodiment, the design layout program interventional instrument includes receiving a model of the anatomical structure. 该解剖学结构包括多个通道。 The anatomical structure comprises a plurality of channels. 方法进一步包括在模型中鉴定目标结构,和接收关于介入器械在多个通道内的操作能力的信息。 The method further comprises identifying a target structure in the model, and the ability to receive information regarding the operation interventional device within the plurality of channels. 方法进一步包括基于介入器械的操作能力,鉴定用于定位介入器械的远端以对目标结构执行程序的设计布置位置(planned deployment location)〇 The method further comprises the operation based on the ability of the interventional instrument, the distal end of the identification for positioning interventional instrument designed to perform the arrangement position of the target program structure (planned deployment location) square

[0007] 在另一实施方式中,系统包括非临时性计算机可读介质,其包含用于设计布置介入器械的程序的计算机可执行指令。 [0007] In another embodiment, the system includes a non-transitory computer-readable medium containing a program for designing arrangement of the interventional instrument computer-executable instructions. 计算机可执行指令包括接收包括多个通道的解剖学结构的模型的指令、和在模型中鉴定目标结构的指令。 Computer-executable instructions comprise receiving instructions including a plurality of models of the anatomy of the channels, and a target instruction identified in the model structure. 计算机可执行指令还包括接收关于介入器械在多个通道内的操作能力的信息的指令、和基于介入器械的操作能力鉴定用于定位介入器械远端以对目标结构执行程序的设计布置位置的指令。 The computer-executable instructions further comprise receiving instructions information about the operational capability of the interventional instrument within the plurality of channels, and the operation is identified based on the ability of the interventional instrument for positioning the distal end of the interventional device in order to design the arrangement position of the target instruction execution program structure .

[0008] 附图简述 [0008] BRIEF DESCRIPTION

[0009] 本公开的方面通过结合附图阅读下文详细描述将得到最充分的理解。 [0009] This aspect of the disclosure by reading the following detailed description in conjunction with the accompanying drawings will be most fully appreciated. 注意,根据工业标准实践,各种要件没有按比例绘制。 Note that, according to industry standard practice, the various elements are not drawn to scale. 事实上,各种要件的尺寸可能为了讨论清楚而任意增加或减少。 In fact, the various elements of the size and clarity of discussion may be arbitrarily increased or reduced. 另外,本公开可在不同的实施例中重复参考编号和/或字母。 Further, the present disclosure may repeat reference numbers and / or letters in the various embodiments. 这样的重复其目的是简单和清楚,而非本身表示所述不同实施方式和/或配置之间的关系。 Such an object is repeated simplicity and clarity, not itself represent a relationship between the various embodiments and / or configurations.

[0010]图1是根据本公开实施方式的远程操作的介入系统。 [0010] FIG. 1 is an interventional system according to the remote operation of the embodiment of the present disclosure.

[0011] 图2示例采用本公开方面的介入器械系统。 [0011] FIG 2 illustrates interventional instrument system aspects of the present disclosure.

[0012] 图3示例具有伸长介入工具的图2的介入器械系统的远端。 [0012] FIG. 3 illustrates a distal end having an elongated interventional tool interventional instrument system of FIG 2.

[0013]图4示例解剖学模型图像,其中介入器械远端处于布置位置。 [0013] FIG 4 illustrates an anatomical model image, wherein the distal end of the interventional instrument is disposed position.

[0014]图5是图4的部分的视图。 [0014] FIG. 5 is a view of a portion of FIG. 4.

[0015]图6示例解剖学模型图像,其中介入器械远端处于基于传感器反馈修正的布置位置。 [0015] FIG. 6 illustrates anatomical model image, wherein the distal end of the interventional instrument is based on sensor feedback correction arrangement position.

[0016]图7是描述鉴定介入器械的设计布置位置的方法的流程图。 [0016] FIG. 7 is a flowchart of a method designed to identify the arrangement position of the interventional instrument is described.

[0017]图8是描述基于传感器反馈修正设计布置位置的方法的流程图。 [0017] FIG 8 is a flowchart of a position sensor feedback correction based on the design of the arrangement described.

[0018]图9是描述利用成像系统鉴定目标结构的方法的流程图。 [0018] FIG. 9 is a flowchart describing an imaging system to identify the target structure using the method.

[0019]图10和11是图9的方法的示例。 [0019] FIGS. 10 and 11 is an example of the method of FIG.

[0020] 发明详述 [0020] DETAILED DESCRIPTION

[0021]在下文对本发明方面的详细描述中,提出了很多具体细节以提供对本公开实施方式的充分理解。 [0021] In the detailed description of the aspects of the invention below, numerous specific details to provide a thorough understanding of embodiments of the present disclosure. 然而,对本领域技术人员显而易见的是,本公开实施方式的实践可无需这些具体细节。 However, the skilled person will be apparent that the present practice of the disclosed embodiments may be practiced without these specific details. 在其他实例中,公知的方法、程序、部件、和电路未被详细描述,从而不会不必要地使本发明实施方式的方面难以理解。 In other instances, well-known methods, procedures, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the embodiments of the present invention is difficult to understand. 而且,为避免不必要的重复描述,根据一个示例性实施方式描述的一个或多个部件或动作在适用于其他示例性实施方式时可被使用或省略。 Further, in order to avoid unnecessary repetition of description, components or one or more actions according to an exemplary embodiment described herein may be used or omitted in its application to other exemplary embodiments. [0022]下文实施方式将就其在三维空间中的状态而言描述不同器械和器械部分。 [0022] Hereinafter embodiments thereof will be described and the different portion of the instrument in the instrument in a state in terms of three-dimensional space. 如本文所用,术语“定位”指代对象或对象的部分在三维空间中的位置(例如,沿笛卡儿X、Y、Z坐标的三个平移自由度)。 As used herein, the term "location" refers to the position of an object or part in the generation of three-dimensional space (e.g., along the Cartesian X, Y, Z coordinates of the three translational degrees of freedom). 如本文所用,术语“定向”指代对象或对象的部分的旋转布置(三个旋转自由度一一例如,滚转、俯仰、和偏转)。 As used herein, the term "oriented" refers to a rotating portion disposed on behalf of the object or objects (e.g. eleven three rotational degrees of freedom, roll, pitch, and yaw). 如本文所用,术语“姿态”指代对象或对象的部分的至少一个平移自由度的定位和对象或对象的部分的至少一个旋转自由度的定向(上至总共六个自由度)。 As used herein, the term "gesture" refers to at least one rotational degree of freedom of at least one translational degree of freedom of the positioning portion and the object or part of an object or generation of orientation (up to a total of six degrees of freedom). 如本文所用,术语“形状”指代沿对象测量的一组姿态、定位、或定向。 As used herein, the term "shape" refers to a group of objects in the generation of measurement posture, position, or orientation.

[0023] 参考附图的图1,用于例如外科、诊断、治疗、或活组织检查程序的远程操作介入系统总体上由参考编号100表示。 [0023] Referring to the drawings of FIG. 1, for example, the remote operation system overall surgical intervention, diagnostic, therapeutic, or biopsy procedure is represented by reference numeral 100. 如图1所示,远程操作系统100总体上包括介入操纵器组件102,用于操作介入器械104对患者P进行不同程序。 1, the remote operation system 100 generally includes a manipulator assembly 102 intervening, the operation for the patient P interventional implement 104 different programs. 组件102安装于操作台0或安装在操作台0附近。 Assembly 102 mounted to the console console installed near 0 or 0. 主组件106允许外科医生S观看外科位点和控制从操纵器组件102。 The main assembly 106 allows the surgeon to view the surgical site S and the manipulator control assembly 102.

[0024] 主组件106可位于外科医生控制台C,外科医生控制台C通常与操作台0位于相同房间。 [0024] The main assembly 106 may be located surgeon's console C, the surgeon console is usually located in the same room C 0 with the workbench. 然而,应理解,外科医生S可与患者P位于不同的房间或完全不同的建筑。 However, it should be understood that the surgeon S can be located in a different room or a completely different building and the patient P. 主组件106总体上包括任选的载体108和一个或多个控制装置112,该控制装置112用于控制操纵器组件102。 The main assembly 106 generally includes a carrier 108 and optionally one or more control devices 112, the control means 112 for controlling the manipulator assembly 102. 控制装置(一个或多个)112可包括任意数量的多种输入装置,如操纵杆、转球、数据手套、触发枪、手动操作控制器、语音识别装置、身体动作或存在传感器、或类似物。 The control device (s) 112 may include any number of a variety of input devices, such as joysticks, track ball, data glove, gun trigger, manually operated controller, a speech recognition device, or the presence of body motion sensor, or the like . 在一些实施方式中,控制装置(一个或多个)112被提供以与关联的介入器械104相同的自由度,以提供给外科医生远程呈现、或控制装置(一个或多个)112与器械104—体的感知,使得外科医生有直接控制器械104的强烈感觉。 In some embodiments, the control device (s) 112 is provided with the same 104 degrees of freedom associated with the interventional device, to provide the surgeon with telepresence, or the control device (s) 112 to the instrument 104 - sensing body, so that the surgeon has direct control of the strong sense of the instrument 104. 在其他实施方式中,控制装置(一个或多个)112可具有比相关介入器械104更多或更少自由度,并且仍提供给外科医生远程呈现。 In other embodiments, the control device (s) 112 may have an associated interventional instrument than 104, more or fewer degrees of freedom to the surgeon and still provide telepresence. 在一些实施方式中,控制装置(一个或多个)112是手动输入装置,其以六个自由度运动,并且还可包括致动手柄,用于致动器械(例如,闭合抓爪、施加电势至电极、递送药物治疗、或类似作用)。 In some embodiments, the control device (s) 112 is a manual input device with six degrees of freedom, and further comprising an actuator handle for actuating the instrument (e.g., the closure catch, applying an electric potential to the electrode, to deliver drugs, or a similar effect).

[0025] 在可选的实施方式中,远程操作系统可包括多于一个从操纵器组件和/或多于一个主组件。 [0025] In an alternative embodiment, the remote operation system may include more than one manipulator assembly, and / or more than one main assembly. 操纵器组件的确切数量将取决于外科程序和操作室内的空间限制、以及其他因素。 The exact number of manipulator assembly will depend on the surgical procedure and operating room space constraints, and other factors. 主组件可并置,或其可定位在单独的位置。 Juxtaposed main assembly, or may be located in a separate location. 多个主组件允许多于一个操作人员控制不同组合的一个或多个从操纵器组件。 A plurality of main assembly allows more than one operator to control one or more components of different combinations of the manipulators.

[0026] 任选的可视化系统110可包括内窥镜系统,使得外科位点同时(实时)图像被提供给外科医生控制台C。 [0026] Optionally visualization system 110 may include an endoscope system, such that the surgical site while the (real) image is supplied to the surgeon's console C. 同时图像可以是例如定位在外科位点内的内窥镜探头拍摄的二维或三维图像。 For example, while the image may be two-dimensional or three-dimensional image is positioned within the surgical site of the endoscopic probe photographed. 在此实施方式中,可视化系统110包括内窥镜部件,其可一体化或可拆卸地偶联于介入器械104。 In this embodiment, the visualization system 110 includes an endoscope member, which may be integral or removably coupled to the interventional instrument 104. 然而,在可选的实施方式中,可利用附接于独立的操纵器组件的独立的内窥镜来成像外科位点。 However, in an alternative embodiment may be utilized independently attached to manipulator assembly independent of the imaging endoscope surgical site. 可选地,独立的内窥镜组件可直接由使用者操作,无远程操作控制。 Alternatively, a separate endoscope assembly may be directly operated by the user, without remote control operation. 内窥镜组件可包括主动转向结构(例如,通过远程操作转向丝)或被动转向结构(例如,通过导丝或使用者直接导航)。 The endoscope assembly may include a active steering structures (e.g., steering wires by remote control) or passive steering structure (e.g., a guidewire or through direct user navigation). 可视化系统110可作为硬件、固件、软件、或其组合实施,其与一个或多个计算机处理器相互作用或被一个或多个计算机处理器执行,该计算机处理器可包括控制系统II6的处理器(一个或多个)。 Visualization system 110 may be implemented as hardware, firmware, software, or a combination thereof, or its interaction with one or more computer processors execute one or more computer processors, the computer processor may include a control system processor II6 (one or more).

[0027]显示系统111可显示可视化系统110拍摄的外科位点和介入器械的图像。 [0027] The display system 111 may display an image captured by the visualization system 110 surgical site and the interventional instrument. 显示器111和主控制装置(一个或多个)112可定向使得显示器组件中的成像装置和介入器械的相对定位类似于外科医生眼和手(一个或多个)的相对定位,因此操作人员可操纵介入器械10^和主控制装置(一个或多个)112,如同观看基本上真实呈现的工作空间。 Display 111 and a main control unit (s) 112 may be oriented such that the relative positioning of the image forming apparatus and interventional instrument display assembly is similar to the surgeon eyes and hands (one or more) relative positioning, so the operator may manipulate 112, as viewed substantially real workspace 10 ^ presented and a main control means interventional instrument (s). 真实呈现意为显示的组织图像呈现给操作人员,如同操作人员亲身存在于成像器位置并且从成像器角度直接观看组织。 Real show tissue image display means is presented to the operator as the operator is present in the person viewing the imaging position and imaging angle directly from the tissue.

[0028]可选地或另外地,显示系统ill可呈现利用成像技术术前记录和/或模拟的外科位点图像,该成像技术如计算机断层(CT)、磁共振成像(MRI)、荧光透视、温度记录法、超声波、 光学相干断层扫描(0CT)、热成像、阻抗成像、激光成像、纳米管X射线成像、或类似技术。 [0028] Alternatively or additionally, the display system may be presented by the front ill imaging operation recording and / or surgical site image simulation, the imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), fluoroscopy , thermography, ultrasound, optical coherence tomography (0CT), thermal imaging, impedance imaging, laser imaging, X-ray imaging nanotubes, or the like. 呈现的术前图像可包括二维、三维、或四维(包括,例如,基于时间或基于速度的信息)图像。 Preoperative rendered image may comprise two, three, or four (including, e.g., time-based or speed information) of the image. [0029]在一些实施方式中,显示系统ill可显示虚拟可视化图像,其中通过来自模拟解剖结构的术前或同时图像定位(例如,动态参照)介入器械的实际位置,以呈现给外科医生S外科器械末端位置处的内部外科位点的虚拟图像。 [0029] In some embodiments, the display system is ill can display a virtual visualization, wherein the preoperative from the analog anatomy or simultaneous image localization (e.g., dynamic reference) the actual position of the interventional instrument, for presentation to the surgeon S Surgery internal surgical site of the virtual image at the position of the instrument tip.

[0030]在其他实施方式中,显示系统111可显示虚拟可视化图像,其中通过来自模拟解剖结构的已有图像(包括术前记录的图像)或同时图像定位介入器械的实际位置,以呈现给外科医生S外科位点处介入器械的虚拟图像。 [0030] In other embodiments, the display system 111 can display a virtual visualization, which through the existing image from the simulated anatomical structure (including the image preoperative recorded) or simultaneously image localization interventional actual position of the instrument, for presentation to the surgical doctors at the site of surgical intervention S virtual image instrument. 部分介入器械的图像可叠加在虚拟图像上,以协助外科医生控制介入器械。 The image part of the interventional instrument can be superimposed on the virtual image to assist the surgeon control of interventional devices.

[0031]在图1中,控制系统II6包括至少一个处理器(未显示),一般包括多个处理器,用于产生从外科操纵器组件10 2、主组件106、可视化系统11 〇、和显示系统丨丨丨之间的控制。 [0031] In FIG 1, the control system comprises at least one processor II6 (not shown), typically comprising a plurality of processors, for generating from the surgical manipulator assembly 102, the main assembly 106, a visualization system 11 billion, and the display system control between Shu Shu Shu. 控制系统116还包括程序指令(例如,存储指令的计算机可读介质),以实施本文描述的一些或全部方法。 Control system 116 further includes program instructions (e.g., computer-readable medium storing instructions) to implement some or all of the methods described herein. 虽然控制系统II6在图1的简化示意图中显示为单个框,但该系统可包括多个数据处理电路(例如,在从外科操纵器组件102上和/或在主组件1〇6上),其中至少部分处理任选地邻近从外科操纵器组件进行,部分在主组件处进行,等等。 Although the control system shown in simplified schematic II6 FIG. 1 as a single block, but the system may comprise a plurality of data processing circuits (e.g., from a surgical manipulator assembly 102 and / or on the main assembly 1〇6), wherein optionally at least partially adjacent to the processing from the surgical manipulator assembly, the main assembly of the parts, and the like. 可利用多种集中式或分布式数据处理架构中的任一种。 It may utilize any of a variety of centralized or distributed data processing architecture. 类似地,程序指令可以多个独立的程序或子程序实施,或其可整合成本文描述的远程操作系统的多个其他方面。 Similarly, the program instructions may be a plurality of separate programs or subroutines embodiments, a plurality thereof may be integrated remote operating cost of the system described elsewhere. 在一个实施方式中,控制系统116支持无线通信协议,如蓝牙、IrDA、HomeRF、IEEE 802.11、DECT、和Wireless Telemetry。 In one embodiment, the control system 116 to support wireless communications protocols, such as Bluetooth, IrDA, HomeRF, IEEE 802.11, DECT, and Wireless Telemetry.

[0032]在一些实施方式中,控制系统II6可包括一个或多个伺服控制器,以向控制装置(一个或多个)112的一个或多个相应的伺服马达提供来自介入器械1〇4的力和扭矩反馈。 [0032] In some embodiments, the control system may comprise one or more II6 servo controller to provide from 1〇4 interventional instrument to the respective servomotor control device (s) 112 to one or more of force and torque feedback. 伺服控制器(一个或多个)也可发送信号,指示操纵器组件丨〇2移动通过身体开口延伸进入患者身体内的内部外科位点的器械。 Servo controller (s) can also send a signal indicating movement of the manipulator assembly by Shu 〇2 instrument body opening extending into the interior surgical site within a patient's body. 可使用任何适当的常规或专用伺服控制器。 Using any suitable conventional or special servo controller. 伺服控制器可独立于操纵器组件102,或与操纵器组件1〇2是一体的。 The servo controller may be independent of manipulator assembly 102, manipulator assembly 1〇2 or is integral. 在一些实施方式中,伺服控制器和操纵器组件被提供作为定位于患者身体邻近的操纵器臂推车的部分。 In some embodiments, the servo controller and manipulator assembly is provided positioned in the body adjacent to the manipulator arm of a patient as part of the cart.

[0033]每个操纵器组件102支持介入器械104,并且可包括一个或多个非伺服控制的连杆的运动结构(例如,可手动定位和锁定就位的一个或多个连杆,被统称为设置结构)和远程操作的操纵器。 [0033] Each manipulator assembly 102 supports interventional instrument 104, and may include one or more of the non-moving structure of servo control link (e.g., a manually positioned and locked in place or a plurality of links, and are collectively referred to structure is provided) and a remotely operated manipulator. 远程操作的操纵器组件102被多个致动器(例如,马达)驱动。 A remotely operated manipulator assembly 102 is a plurality of actuators (e.g., motors) drive. 这些马达响应控制系统116的命令,主动驱动远程操作的操纵器。 The response control system commands the motor 116, actively driven remotely operated manipulator. 马达进一步偶联于介入器械,从而驱动介入器械进入自然或外科形成的解剖学孔口和以多个自由度移动介入器械的远端,该自由度可包括三个线性运动度(例如,沿X、Y、Z笛卡儿轴的线性运动)和三个旋转运动度(例如, 围绕X、Y、Z笛卡儿轴旋转)。 The motor is further coupled to the interventional device, thereby driving the interventional device into the natural anatomic or surgical orifice formed in a plurality of degrees of freedom of movement and to the distal end of interventional instrument, which may comprise three degrees of freedom of linear motion (e.g., along the X , Y, Z Cartesian axes of linear motion) and three rotational degrees of motion (e.g., X-around, Y, Z Cartesian axis). 另外地,马达可用于致动器械的铰接末端执行器以在活组织检查装置的夹钳或类似物中抓握组织。 Further, the motor for articulating the end effector can be actuated to grasp the instrument clamps tissue in a biopsy device, or the like.

[0034]图2不例米用本公开方面的微创系统200。 [0034] FIG 2 meters with the present embodiment is not minimally invasive system 200 disclosed aspects. 系统200可被并入远程操作的介入系统, 如系统100。 The system 200 may be incorporated into interventional system remotely operated, such as system 100. 可选地,系统200可用于探查程序或涉及传统手动操作的介入器械如腹腔镜器械的程序。 Alternatively, the system 200 may be a program or a program for probing conventional manual operations involving interventional instrument such as a laparoscopic instrument. 系统2〇〇包括导管系统2〇2(例如,器械104的部分),其通过接口单元204偶联于跟踪系统206。 The system includes a catheter 2〇〇 2〇2 system (e.g., the portion of the instrument 104), by the interface unit 204 coupled to the tracking system 206. 穿行系统210 (例如,控制系统116的部分)处理来自虚拟可视化系统208、一个或多个成像系统212、和/或跟踪系统2〇6的信息,以在显示系统2丨4(例如,显示系统in的部分)上生成一个或多个图像显示。 Walking through the system 210 (e.g., the system control section 116) of the processing information of the imaging system 212, and / or tracking system 2〇6 from virtual visualization system 208, one or more, Shu 2 to 4 in the display system (e.g., the display system in part generate one or more image display). 系统200可进一步包括任选的操作和支持系统(未显示), 如照明系统、转向控制系统、灌洗系统和/或抽吸系统。 The system 200 may further comprise an optional operations and support systems (not shown), such as a lighting system, the steering control system, irrigation system, and / or a suction system.

[0035]导管系统2〇2包括细长烧性体216,其具有近端217和远端2丨8。 [0035] The catheter system includes an elongate firing of 2〇2 216, having a proximal end and a distal end 217 Shu 2 8. 管道219在烧性体216内延伸。 Conduit 219 extends within the firing of 216. 在一个实施方式中,烧性体216具有约3mm外径。 In one embodiment, the firing of about 216 having an outer diameter of 3mm. 其他挠性体外径可较大或较小。 Other flexible outer diameter may be larger or smaller. 导管系统2〇2任选地包括传感器系统,其包括定位传感器系统220 (例如,电磁(EM)传感器系统)和/或形状传感器系统222—一用于确定远端218处导管末端和/或沿主体216—个或多个节段224的定位、定向、速度、姿态、和/或形状。 The catheter system 2〇2 optionally includes a sensor system that includes a positioning sensor system 220 (e.g., electromagnetic (EM) sensor systems) and / or shape of the sensor system for determining a 222- tip at the distal end of catheter 218 and / or along the 216- or more body segments 224, the positioning, orientation, speed, attitude, and / or shape. 远端218和近端217之间的主体216的全长可有效分成节段224。 The entire length of the body 216 between proximal end 217 and distal end 218 may be effectively divided into 224 sections. 定位传感器系统220和形状传感器系统222与跟踪系统206对接。 Positioning sensor system 220 and the shape of the sensor system 222 and tracking system 206 docking. 跟踪系统206可作为与一个或多个计算机处理器相互作用或被一个或多个计算机处理器执行的硬件、固件、软件或其组合来实施,该计算机处理器可包括控制系统i 16的处理器。 Tracking system 206 may be implemented as hardware, firmware, software, or interacts with one or more computer processors execute one or more computer processors, or a combination thereof, the computer processor may include a control system 16 of processor i .

[0036]定位传感器系统220可以是EM传感器系统,其包括一个或多个传导线圈,该传导线圈可被给予外部生成的电磁场。 [0036] The positioning system 220 may be a sensor EM sensor system, comprising one or more conductive coils, the conductive coil can be administered externally generated electromagnetic fields. 因此,EM传感器系统220的各线圈产生感应电信号,其特征取决于线圈相对于外部生成的电磁场的定位和定向。 Thus, each coil 220 of the EM sensor system generates the electrical signals, depending on which coil relative to the externally generated electromagnetic field positioning and orientation. 在一个实施方式中,EM传感器系统可被配置和定位以测量六个自由度,例如,三个定位坐标X、Y、Z和三个定向角——表示基点的俯仰、偏转、和滚转。 In one embodiment, the EM sensor system may be configured and positioned to measure six degrees of freedom, e.g., three positioning coordinates X, Y, Z and three orientation angles - point represents the pitch, yaw, and roll. EM传感器系统的进一步描述被提供于1999年8月11日提交的美国专利56,380,732,其公开了"Six-Degree of Freedom Tracking System Having a Passive Transponder on the Object Being Tracked'其全部内容被引入本文作为参考。 Further described EM sensor system is provided in U.S. Patent on August 11, 1999, filed 56,380,732, which discloses "Six-Degree of Freedom Tracking System Having a Passive Transponder on the Object Being Tracked 'the entire contents of which are incorporated herein by reference .

[0037]形状传感器系统222包括与挠性体216对齐的光纤(例如,在内部管道(未显示)中提供或外部安装)。 [0037] The shape of the sensor system 222 includes an optical fiber 216 aligned flexible body (e.g., in the inner pipe (not shown) provided in or externally mounted). 跟踪系统2〇6可偶联于光纤近端。 2〇6 tracking system can be coupled to the proximal end of the optical fiber. 在一个实施方式中,光纤直径为约2〇〇ym。 In one embodiment, the fiber diameter of about 2〇〇ym. 在其他实施方式中,该尺寸可更大或更小。 In other embodiments, the dimensions may be larger or smaller.

[0038]形状传感器系统222的光纤构成光纤弯折传感器,用于确定导管系统202的形状。 [0038] The shape of the optical fiber sensor system 222 constituting the optical fiber bending sensor, for determining the shape of the catheter system 202. 在一种可选方式中,利用包括光纤布拉格光栅(Fiber Bragg Gratings,FBGs)的光纤提供一个或多个维度的结构中的应变测量。 In an alternative embodiment, the structure comprises a fiber strain measurement using a fiber Bragg grating (Fiber Bragg Gratings, FBGs) to provide one or more of the dimensions. 多种监测光纤形状和在三个维度的相对定位的系统和方法被描述于2005年7月13日提交的美国专利申请号11/180,389,其公开了〃Fiber optic position and shape sensing device and method relating thereto";2004年7 月ie日提交的美国临时专利申请号60/588,336,其公开了〃Fiber—〇ptic shape and relative position sensing〃 ;和1998年6月17 日提交的美国专利号6,389,187,其开了" Optical Fibre Bend Sensor〃,其全部内容被引入本文作为参考。 Monitoring various shapes and fiber is described in U.S. Patent Application No. 2005, filed on July 13 in the relative positioning system and method for three dimensional 11 / 180,389, which discloses 〃Fiber optic position and shape sensing device and method relating thereto "; US provisional Patent application No. ie July 2004, filed 60 / 588,336, which discloses 〃Fiber-〇ptic shape and relative position sensing〃; and US Patent No. 1998, June 17 filed 6,389,187, which is open "Optical Fibre Bend Sensor〃, the entire contents of which are incorporated herein by reference. 在其他可选方式中,利用其他应变感应技术如瑞利散射、拉曼散射、布里渊散射、和荧光散射的传感器可以是适当的。 In another alternative, such as Rayleigh scattering, Raman scattering, Brillouin scattering, scattering and fluorescence sensor may utilize other suitable strain sensing technology. 在其他可选的实施方式中,可利用其他技术确定导管的形状。 In other alternative embodiments, the shape of the catheter may be determined using other techniques. 例如,如果导管远端姿态历史存储的时间间隔小于更新穿行显示或交替动作(例如,吸入和呼出)的时间,则可利用姿态历史重构经过该时间间隔的装置形状。 For example, if the posture of the distal end of the catheter is stored history update time interval is less than or walking show alternate action (e.g., inhaled and exhaled) time, the shape of the posture history reconstruction means through the time interval can be utilized. 作为另一实例,可存储随同交替动作循环如呼吸的器械已知点的历史姿态、定位、或定向数据。 As another example, the operation may be stored along with alternate cycles such as historical posture breathing apparatus known point, location, or orientation data. 这种存储数据可用于建立关于导管的形状信息。 Such data may be used to store information about the establishment of the shape of the catheter. 可选地,沿导管定位的一系列定位传感器,如EM传感器,可用于形状感应。 Alternatively, a series of positioning the positioning along the conduit sensors, such as EM sensor, shape sensor may be used. 可选地,程序期间来自器械上的定位传感器如EM传感器的数据历史可用于表示器械的形状,特别是在解剖学通道总体上静止的情况下。 Alternatively, the sensor is positioned during the procedure from the instrument, such as historical data may be used to form EM sensors represent the instrument, especially in a case where the channel anatomically generally stationary. 可选地,定位或定向受外部磁场控制的无线装置可用于形状感应。 Alternatively, the wireless device positioned or oriented by an external magnetic field may be used to control the shape of the induction. 其定位历史可用于确定穿过通道的形状。 Positioned through the history it can be used to determine the shape of the channel.

[0039]在此实施方式中,光纤可在单个包层内包括多个核。 [0039] In this embodiment, the optical fiber may include a plurality of cores within a single cladding. 每个核可以是单模,具有使核分隔的充足距离和包层,使得各核的光不与其他核携载的光发生显著相互作用。 Each core may be a single mode, has a core and cladding sufficient distance separated, so that the light of each core do not significantly interact with the light generating carried in other cores. 在其他实施方式中,核数量可改变,或每个核可被包含在独立的光纤中。 In other embodiments, the core may vary the number, or each core may be contained in a separate fiber.

[0040]在一些实施方式中,FBG阵列被提供在每个核内。 [0040] In some embodiments, FBG array is provided within each nucleus. 每个FBG包括核折射指数的一系列调制,从而生成折射指数的空间周期性。 Each FBG core comprising a series of refractive index modulation, thereby generating a spatially periodic refractive index. 可选择间距,使得源自各指数变化的部分反射对于窄带波长相干叠加,因此在经过较宽的带时仅反射这种窄带波长。 Alternatively the pitch, such that each derived from a partially reflective index changes for narrowband wavelength coherent addition, only the reflection wavelength passes narrowband wider band. 在制造FBG的过程中, 调制间隔已知距离,从而引起已知波长带的反射。 In the process of manufacturing the FBG, the modulation spaced a known distance, thereby causing the reflection wavelength band is known. 然而,当在纤维核上引起应变时,调制间距将根据核应变量而改变。 However, when a strain is caused in the fiber core spacing will vary depending on the modulation core of strain. 可选地,随光纤弯折而改变的反向散射或其他光学现象可用于确定各核中的应变。 Alternatively, the optical fiber is bent with changes backscatter or other optical phenomena can be used to determine the strain of each core.

[0041 ]因此,为测量应变,沿纤维发送光,并且测量返回光的特征。 [0041] Accordingly, to measure strain along the transmission optical fiber, and measuring the characteristics of the return light. 例如,FBG产生的反射波长是纤维应变和其温度的函数。 For example, the FBG reflection wavelength and fiber strain is generated in a function of temperature. 这种FBG技术可购自多个来源,如Smart Fibres Ltd.of Bracknell,英国。 Such FBG technology commercially available from a number of sources, such as the Smart Fibres Ltd.of Bracknell, England. FBG技术在用于远程操作手术的定位传感器中的应用被描述于2〇〇6年7月20日提交的美国专利号7,930,065,其公开了1〇13以:^3111'狀137#_1此111(111^ Position Sensors Using Fiber Bragg Gratings'其全部内容被引入本文作为参考。 [0042]在应用于多核纤维时,光纤的弯折引起核上的应变,该应变可通过监测各核的波长转变来测量。通过纤维中具有偏轴布置的两个或更多个核,纤维弯折在各核上引起不同的应变。这些应变是局部纤维弯折度的函数。例如,包含FBG的核区域,如果位于纤维弯曲的点,则可从而用于确定那些点的弯折量。这些数据与FBG区域的已知间距组合,可用于重构纤维的形状。这种系统以己被Luna Innovations. Inc.of Blacksburg,Va描述。 Application of FBG sensor positioning technique for remotely operating procedures are described in U.S. Patent No. 6 2 billion billion July 20, filed 7,930,065, which discloses in 1〇13: 3111 ^ 'like this _1 137 # 111 (111 ^ Position Sensors Using fiber Bragg Gratings' entire contents of which are incorporated herein by reference. [0042] when applied to a multi-core fiber, the fiber bending strain is caused on the core, the strain can be transformed by the wavelength monitor the core measured by the fiber having an off-axis arrangement of two or more cores, each core in the fiber is bent due to the different strain. these strains are partially a function of the degree of bending of the fibers. For example, the core region comprising a FBG, if fiber bending point is located, so that can be used to determine the amount of bending of those points. these data combined with the pitch of the FBG region is known, can be used to reconstruct the shape of fibers. in such a system had been Innovations Luna. Inc.of Blacksburg, Va described.

[0043]如述,光纤可用于监测至少部分导管系统202的形状。 [0043] As described above, the optical fiber can be used to monitor the shape of at least a portion of the catheter system 202. 更具体地,通过跟踪系统206 处理经过光纤的光,以检测导管系统202的形状和利用该信息协助外科程序。 More specifically, the processing by the tracking system 206 through the optical fiber, the shape of the catheter system 202 to detect and use that information to assist the surgical procedure. 跟踪系统206 可包括检测系统,其用于生成和检测用于确定导管系统202的形状的光。 Tracking system 206 can include a detection system for the catheter system 202 shapes the light generation and detection means for determining. 此信息进而可用于确定其他相关变量,如介入器械的部分的速度和加速度。 This information in turn can be used to determine other variables, such as the portion of the interventional instrument velocity and acceleration. 感应可仅限于被远程操作系统致动的自由度,或可应用于被动(例如,接头之间刚性元件的非致动型弯折)和主动(例如,器械的致动运动)自由度。 Induction can only be actuated degree of freedom in the remote operation system, or may be applied to a passive (e.g., non-rigid element between the joint bending actuation) and active (e.g., instrument actuation motion) degrees of freedom.

[0044]挠性体2丨6可任选地容纳一个或多个图像拍摄探头226,其发送拍摄的图像数据至成像系统(一个或多个)212。 [0044] The flexible member 2 Shu 6 optionally accommodate one or more image capturing probes 226, which transmits captured image data to the imaging system (s) 212. 例如,图像拍摄探头226可以是内窥镜探头,包括具有立体或单像摄像机的末端部分,该立体或单像摄像机布置在挠性体216的远端218附近,用于拍摄发送至成像系统212的图像(包括视频图像)。 For example, the probe 226 may be an image pickup endoscopic probe, comprising a three-dimensional image or a single end portion of the camera, the stereoscopic or monoscopic video camera disposed near the distal end 218 of flexible body 216 for photographing is transmitted to the imaging system 212 image (including video image). 图像拍摄探头226可包括偶联于摄像机、用于发送拍摄的图像数据的线缆。 Image pickup probe 226 may include a camera coupled to, a cable for transmitting captured image data. 可选地,图像拍摄器械可以是偶联于成像系统的光纤束,如纤维镜。 Alternatively, the image capturing device may be coupled to a fiber bundle of an imaging system, such as a fiberscope. 图像拍摄器械可以是单光谱或多光谱的,例如获取可见光谱的图像数据、或获取可见和红外或紫外光谱的图像数据。 The image capturing device may be a single or multi-spectral spectra, for example, acquires image data of the visible spectrum, and the visible image data acquisition or infrared or ultraviolet spectrum.

[0045]另外地或可选地,图像拍摄探头226可以是传感器探头,与反射成像技术如超声波或光学相干断层扫描(OCT) —起应用。 [0045] Additionally or alternatively, the image-capturing sensor 226 may be a sensor probe, the reflective imaging techniques such as ultrasonic or optical coherence tomography (OCT) - from the application. 例如,该探头可包括发送器和接收器布置,如超声换能器。 For example, the probe may include a transmitter and receiver arrangement, such as an ultrasound transducer. 超声换能器可被安装在细长轴的一端。 Ultrasonic transducers may be mounted at one end of the elongated shaft. 这样的来源可用于获得将要进行介入程序的解剖学区域的术前或术中二维或三维图像或模型。 Such sources can be used before surgery or surgery to get involved in the program will be carried out anatomical region in two or three dimensional image or model. 作为二维来源,超声换能器可用于获得单一超声波图像。 Source of two-dimensional ultrasonic transducer may be used to obtain a single ultrasound image. 作为三维来源,其可用于获得多个空间超声图像或剪辑(cuts),从而提供足以构^三维模型的信息。 A three-dimensional source, which may be used to obtain an ultrasound image or plurality of spatial clip (Cuts), thereby providing sufficient configuration information ^ three-dimensional model. 因此,其可被安排在解剖学位点内运动(包括旋转),以拍摄这种图像或剪辑。 Thus, it may be arranged movement (including rotation) within the anatomical site, or to capture such an image clip. 这一般可例如根据如下实现:通过远程操作控制移动超声波换能器的预编程顺序,手动移动超声换能器,或类似方式。 This can generally be achieved, for example, according to the following: a remote control operation by the movement of the ultrasonic transducer preprogrammed sequence, the manual movement of the ultrasound transducer, or the like.

[0046]主体216还可容纳线缆、连杆、或在接口204和远端末梢218之间延伸以例如如远端虚线版本所示可控地弯折或转动远端218的其他转向结构控制(未显示)。 [0046] The body 216 may also receive a cable, rod, or the interface 204 and extends between the distal tip 218 as for example shown rotated controllably bent or broken line versions of the distal end of the distal end 218 of another configuration of the control steering (not shown). 导管系统可以是可转向的,或可选地,可以是不可转向的,不具有用于操作人员控制器械弯折的整合机构。 The catheter system may be steerable, or alternatively, may be non-steerable, it does not have a mechanism for integrating the operator to control the instrument bent. 挠性体216可进一^容纳控制机构(未显示),用于操作外科末端执行器或另一可操纵用于医疗功能(例如进行目标组织的预定治疗)的远侧工作部分。 The flexible member 216 may be ^ received into a control mechanism (not shown) for operating a surgical end effector for use in medical or other manipulatable feature (e.g., treatment for a predetermined target tissue) of the distal working portion. 例如,一些末端执行器具有单个工作元件,如手术刀^刀片、光纤、或电极。 For example, some end effectors have a single working element, such as ^ a scalpel blade, an optical fiber, or an electrode. 其他末端执行器可包括成对或多个工作元件, 如例如钳子、抓取器、剪刀、或施夹器。 Other end effector may include a pair or a plurality of work elements, such as for example forceps, grasper, scissors, or clip appliers. 电激活末端执行器的实例包括电外科电极、换能器、 传感器、及类似物。 Examples of electrical activation of the end effector comprises an electrosurgical electrodes, transducers, sensors, and the like.

[0047]如图3更详细显示,用于诸如手术、活组织检查、烧蚀、照明、灌洗或抽吸的程序的介入工具(一个或多个)228可通过管道219布置,并且在解剖结构之内的目标位置处应用。 [0047] shown in greater detail in FIG. 3, interventional tools such as surgery, biopsy, ablation, lighting, irrigation or aspiration procedure for the (s) 228 may be disposed through the conduit 219, and the anatomically application at a target location within the structures. 椎间工具228也可以是图像拍摄探头。 Intervertebral tool 228 may be an image captured probe. 该工具228可从管道219的开口被推动,以执行程序, 然后在程序完成时撤回管道。 The tool 228 may be pushed from the opening of the pipe 219, to execute the program, and then the withdrawal conduit when the program is completed. 介入工具228可从导管挠性体的近端217或另一沿挠性体任选的器械端口(未显示)移除。 Interventional tool 228 may be removed from the proximal end of the catheter 217 or another flexible member along the flexible body optionally instrument port (not shown).

[0048]虚拟可视化系统208给导管系统2〇2提供穿行协助。 [0048] virtualization visualization system 208 provides assistance to walk through the catheter system 2〇2. 利用虚拟可视化系统的虚拟穿行基于对已获得的与解剖学通道的三维结构相关的数据组的参考。 Visualization system using a virtual walk through a virtual reference data set based on the three-dimensional structure has been obtained related to the anatomical passageway. 更具体地,虚拟可视化系统208处理利用成像技术如计算机断层(CT)、磁共振成像(MRI)、荧光透视、温度记录法、 超声波、光学相干断层扫描(0CT)、热成像、阻抗成像、激光成像、纳米管x射线成像、或类似技术记录和/或模拟的外科位点的图像。 More specifically, the virtual visualization system 208 processes using imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (0CT), thermal imaging, EIT, laser imaging, x-ray imaging nanotubes, or similar techniques recording and / or images simulated surgical site. 利用软件将记录的图像转换成部分或全部解剖器官或解剖区域的二维或三维模型。 Software using the recorded image into a part or all of two or three dimensional model of an anatomical organ or anatomical region. 模型描述通道的不同位置和形状及其连通性。 Its different positions and shapes of the model described communication channels. 用于生成模型的图像在临床程序中可被术前或术中记录。 For generating a model image in the clinical program may be recorded prior to surgery or surgery. 在可选的实施方式中,虚拟可视化系统可利用标准模型(即,非患者特异性)或标准模型和患者特异性数据的混合。 In an alternative embodiment, the virtual visualization system may be mixed and the standard model or patient-specific data using a standard model (i.e., non-patient-specific). 模型和通过模型生成的任何虚拟图像可代表可变形解剖区域在一个或多个动作阶段期间(例如,在肺吸气/ 呼气循环期间)的静止姿态。 Any virtual image model generated by the model, and may represent a deformable anatomical region during one or more stages of operation (e.g., in the lung during the inspiratory / expiratory cycles) static posture.

[0049]在虚拟穿行程序期间,传感器系统可用于计算器械相对于患者解剖结构的大概位置。 [0049] The procedure during the virtual walking, the sensor system may be used to calculate the approximate position of the instrument relative to the patient's anatomy. 该位置可用于生成患者解剖结构的宏观水平跟踪图像和患者解剖结构的虚拟内部图像。 This position may be used to generate a virtual image the internal images of the macroscopic level to track the patient's anatomy and the patient's anatomy. 己知多种利用光纤传感器定位和显示介入实施以及术前记录外科图像(如来自虚拟可视化系统的那些)的系统。 Using a variety of known fiber optic sensor is positioned, and a display system of the recording and surgical intervention embodiment preoperative image (such as those from the virtual visualization system) is. 例如2〇11年5月13日提交的美国专利申请号13/107,562—一其公开了,Medical System Providing Dynamic Registration of a Model of an Anatomical Structure for Image-Guided Surgery'其全部内容被引入本文作为参考一一公开了一种这样的系统。 2, for example, U.S. Patent Application No. 11 billion, filed on May 13, 13 / a which discloses 107,562-, Medical System Providing Dynamic Registration of a Model of an Anatomical Structure for Image-Guided Surgery 'the entire contents of which are incorporated herein by reference eleven discloses one such system.

[0050]穿行系统210,作为控制系统116的一部分,处理来自虚拟可视化系统208、一个或多个成像系统212、和/或跟踪系统2〇6的信息,以确定介入器械经过解剖学系统到达目标解剖学结构的穿行路径。 [0050] walk through system 210, as part of the control system 116, the processing information of the imaging system 212, and / or tracking system 2〇6 from virtual visualization system 208, one or more, in order to determine the interventional instrument through the anatomy to reach the target system walking path anatomy. 穿行系统210还可在介入器械经过解剖学系统向目标结构移动时监测介入器械的穿行路径。 The system 210 may also walk through walking path interventional instrument is passed through the target anatomical structure of the monitoring system moves to the interventional instrument. 穿行系统210包括设计模块211,其使临床医生在通过虚拟可视化系统208制备的解剖学模型中定位目标解剖学结构(例如,肿瘤)和鉴定通过解剖学通道到达目标结构从而用介入器械进行介入程序(例如,活组织检查)的穿行路径。 Crossed design module 211 includes a system 210 that enables a clinician anatomical model targets prepared by virtual anatomy visualization system 208 (e.g., a tumor), and arrive at the target identified by the anatomical structure of the channel thereby performing interventional procedures interventional instrument (e.g., biopsy) of the walking path. 目标定位和穿行路径确定可以自动化,使得穿行系统鉴定一种或多种穿行路径。 Targeting and walking path determination can be automated, so that the system identifying one or more walk through walking path. 可选地,临床医生可通过解剖学模型确定穿行路径,并且任选地将选定的路径通信至穿行系统。 Alternatively, the clinician may be determined by the anatomical model of the walking path, and optionally the selected path to walk through a communication system. 在再一可选方式中, 设计模块采用混合自动化/临床医生选择型穿行路径确定,其中临床医生可修改系统设计的路径或其中临床医生可输入参数如要回避的解剖学区域或对设计模块212所建议的设计穿行路径进行限制的器械限制。 In a further alternative embodiment, the module design of hybrid automatic / selective clinical physician determines walking path, wherein the clinician may modify the path of the system design or anatomical region wherein the clinician may input or parameter to be avoided as the design module 212 the proposed walking path instrument designed to limit restrictions.

[0051]穿行设计模块生成或允许临床医生选择在解剖学通道内的设计布置位置,以停放介入器械的远端,从而实施介入程序。 [0051] The design module generates a walking or designed to allow the clinician to select a position disposed within the anatomical passage to the distal end of the parking interventional instrument, so that the interventional procedure. 现参考图4,显示目标结构3〇2如肿瘤的和附近解剖学通道304的虚拟图像300。 Referring now to Figure 4, a target structure such as a tumor near 3〇2 anatomical image 300 virtual channels 304. 该通道包括通道壁306和隆突308。 The channel comprises channel walls 306 and 308 of the keel. 在此实施方式中,解剖学通道是肺支气管,但本公开的系统和方法可适用于解剖学系统如结肠、肠、肾、心脏、或循环系统中其他自然或外科产生的通道。 In this embodiment, the channels are bronchopulmonary anatomy, the present system and method disclosed herein is applicable to anatomical systems, such as colon, intestine, kidney, heart, circulatory system or channel other natural or surgical generated. 显示具有挠性体309 (基本上类似于挠性体216)和伸长介入工具310的介入器械。 A display having a flexible body 309 (substantially similar to the flexible body 216) and the elongate interventional instrument interventional tool 310. 在一个实施方式中,穿行设计模块将设计布置位置鉴定为沿解剖学通道壁、最接近或临近目标结构的位置312。 In one embodiment, design module design walk through the arrangement position along the identified anatomical channel wall, or adjacent to position 312 closest to the target structure. 然而,完全基于目标结构的接近度来选择布置位置可导致介入器械不可到达或不容易到达所选择的布置位置。 However, based entirely on the proximity of a target structure arranged in a position to select the interventional instrument may result not easy to reach or can not reach the position of the selected arrangement. 例如,介入器械可能不能在通道内充分弯折,以到达基于接近度的布置位置。 For example, the interventional device may not be sufficiently bent in the passage to reach a position proximity-based arrangement. 另外,选择的布置位置或通向布置位置的穿行路径可能没有考虑要回避的解剖结构限制,如疤痕或患病组织。 In addition, the selected arrangement position or walk through the path leading to the placement location may not be considered to limit the anatomy to be avoided, such as scarring or diseased tissue.

[0052]在其他实施方式中,穿行设计模块基于多种因素选择布置位置,在一些情况下该因素可以是程序特征,如至目标结构的距离,和/或目标结构相对于其他解剖学特征的定位。 [0052] In another embodiment, the module design based on various factors crossed arrangement position of choice, this factor may in some cases be a program features, such as distance to the target structure, and / or target structure relative to other anatomical features positioning. 在其他实施方式中,另外地或可选地,穿行设计模块可接收和利用关于介入器械操作能力的信息来确定布置位置。 In other embodiments, additionally or alternatively, may receive and walk through the design module is arranged to determine the position information about the interventional procedure using the instrument capability. 例如,可考虑关于器械弯折能力的信息,如导管材料的挠性和弹性、经过导管管道的导管或工具的任何预成形的形状特征、导管或工具远端的转向性(例如,导管远端相对于导管主轴可弯曲的程度)、和沿导管长度的曲度。 For example, the device may consider information regarding bending ability, such as flexibility and elasticity of the catheter material, shape feature through any preformed catheter tube catheter or tool, the distal end of a catheter or a steering tool (e.g., the distal end of the catheter degree with respect to the catheter shaft may be bent), and the curvature along the length of the catheter. 介入器械的其他特征可也用于确定布置位置,包括导管直径、工具直径、从导管伸出时的工具轨迹(例如,弯曲、 笔直)、工具运动(例如,横扫、旋转、线性)、工具轴与导管轴的最大成角、工具可从导管伸出的最大长度、和导管远端提供与通道壁摩擦接触的任何锚定结构。 Other features of the interventional instrument may be also used to determine the position of arrangement, comprising conduit diameter, tool diameter, tool trajectory extending from the catheter (e.g., curved, straight), movement of the tool (e.g., swept, rotation, linear), the tool shaft and the catheter shaft into the maximum angle, the maximum length of the tool may extend from the catheter, the distal end of the catheter and any anchoring structure frictional contact with the channel wall. 关于弯折能力的信息和/ 或关于介入器械特征的信息是可用于确定介入器械在解剖学通道中的操作能力的示例性因素。 Information about the bending capability and / or information about the characteristics of the interventional instrument that may be used to determine factors involved exemplary operational capability of the instrument in the anatomic passage.

[0053]穿行设计模块还可或可选地可接收和利用关于患者解剖结构的信息来确定布置位置。 [0053] The design module is further crossed or alternatively may receive and use information to determine the arrangement position on the patient's anatomy. 这种信息可包括,例如,与目标结构最接近的解剖学通道隆突的位置和与目标结构最接近的通道尺寸。 Such information may include, for example, a position closest to the target anatomical structure and the passage of the keel with the proposed structure closest to channel dimensions. 其他解剖学信息可包括解剖学通道的弹性,包括任何疾病过程可能对通道弹产生的影响。 Other anatomical information may include an elastic anatomical passageway, including any disease process may affect the passage of the projectile generated. 穿行设计模型还可考虑周围解剖学组织,以例如选择减少对周围组织的风险的布置位置。 Walk through the design model can also consider the surrounding anatomical tissue, for example, choose to reduce the risk of the arrangement position of surrounding tissue. 作为一个实例,可选择远离肺周边的布置位置,以避免肺被布置工具穿刺的风险。 As one example, selectively disposed away from the position of the periphery of the lung, the lungs are disposed so as to avoid the risk of puncture tool. 穿行设计模型还可考虑通向目标结构优选位置的目标结构的解剖学。 Design considerations leading to the model may also walk through the target anatomical structure of the preferred position of the target structure. 例如,可选择布置位置,使得活组织检查工具避开肿瘤的钙化部分。 For example, select the arrangement position, so avoiding calcification biopsy tool part of the tumor.

[0054]穿行设计模块还可考虑介入器械和患者解剖结构之间的关系的相关信息,如目标结构与导管末端的距离。 [0054] The module may walk through design considerations related information intervention apparatus and the relationship between the patient anatomy, such as the distance of the target structure and the catheter tip. 参考图5,穿行设计模块还可考虑介入工具和通道壁之间的啮入角320。 Referring to Figure 5, the module design is also conceivable walking engagement between the channel walls and the interventional tool 320 angle. 例如,90°的啮入角由于通道尺寸和导管远端弯折性小而可能是不可实践的。 E.g., 90 ° angle of biting the channel dimensions due to bending and the distal end of the catheter is small and may not be practical. 1°的啮入角由于介入工具可擦过而非穿透通道壁表面的风险也可能是不适当的。 The nip angle 1 ° by the intervention tool can not penetrate the risk rubbed surface of the channel wall may be inappropriate. 基于这些理由,穿行设计模块可选择布置位置,使得啮入角在约30 °和90 °之间。 For these reasons, the design module selectively disposed walking position, such that the nip angle between about 30 ° and 90 °.

[0055]再参考图4,在穿行设计模块评价介入器械和患者解剖结构相关因素后,鉴定解剖学通道壁上的布置位置314。 After [0055] Referring again to FIG. 4, interventional instruments and related factors in patient anatomy walking evaluation module design, identify anatomical position 314 is disposed on the channel walls. 任选地,穿行设计模块可提供通向布置位置的建议穿行路径。 Optionally, design module may walk through walking path to advise arrangement positions. 然后临床医生可将介入器械远端引导至布置位置。 The clinician may then be guided to the distal end of the interventional instrument disposed position. 临床医生可基于虚拟或实际图像指导手动控制介入器械的穿行。 Clinicians walk through interventional devices can be controlled based on virtual or real images to guide manual. 可选地,临床医生可远程操作地控制介入器械的穿行,或允许介入器械沿建议的穿行路径被计算机控制穿行。 Alternatively, the clinician may walk through remote operation control of the interventional instrument, or to allow walking along the path of the interventional instrument is recommended walking through computer control. 在介入器械的远端定位在布置位置后,介入工具从导管伸出,穿过通道壁并接触目标结构。 Positioned at the distal end of the interventional instrument is disposed in the position, interventional tool from the conduit extends through the channel and contacts the walls of the target structure. 在一些情况下,例如,在目标结构位于解剖学通道内时,布置位置可定位在通道腔内,而非通道壁上。 In some cases, e.g., when a target anatomical structure is located within the passage, the arrangement position may be positioned in the channel cavity, and not the channel walls. 例如在目标结构处于通道内时,布置位置可处于目标结构的表面上。 For example, when the target is within the channel structure, it can be arranged at a position on the surface of the target structure.

[0056]图7是描述穿行设计模块鉴定介入器械的设计布置位置所用的方法400的流程图。 [0056] FIG. 7 is a flowchart of a method designed to walk through the identification module design layout position of the interventional instrument 400 is used is described. 在402,接收解剖学结构的模型。 At 402, the model receiving anatomy. 该解剖学结构包括通过该模型示例的多个解剖学通道。 The anatomical structure comprises a plurality of channels through which the anatomical model example. 模型由术前或术间利用成像技术如CT、MRI、荧光透视、温度记录法、超声波、0CT、热成像、阻抗成像、激光成像、纳米管X射线成像、或类似技术记录和/或模拟的外科位点的二维或三维图像形成。 Model preoperatively or intra-operative use of imaging techniques such as CT, MRI, fluoroscopy, thermography, ultrasonic, 0CT, thermal imaging, impedance imaging, laser imaging, the nanotube X-ray imaging, or similar techniques for recording and / or analog forming two or three dimensional image of the surgical site. 模型的接收可包括接收由模型、描述患者解剖结构的使用者输入、或其他参考来源获得的关于患者解剖结构的信息。 Receiving may include receiving, by the model model that describes the patient's anatomy user input, or information regarding the patient's anatomy to other reference sources. 关于患者解剖结构的这种信息可包括,例如,解剖学通道(一个或多个)内与目标结构最接近的位置(一个或多个)、与目标结构最接近的解剖学通道隆突的位置、和与目标结构最接近的通道的尺寸。 Such information about the anatomy of a patient may include, for example, within the anatomical passageway (s) with the proposed structure closest to the position (s), the closest position of the anatomical structure of the target channel keel , closest to the size and structure of the target channel. 其他解剖学信息可包括解剖学通道的弹性、通向目标结构优选位置的目标结构的解剖结构、和周围组织类型和任何与接触周围组织相关的风险。 Other anatomical information may include an elastic anatomical passageway leading to the target position of the structure of a preferred structure of the target anatomical structure, and the surrounding tissue type, and any risks associated with contact with the surrounding tissue.

[0057] 在404,在模型中鉴定目标结构(例如,肿瘤)的位置。 [0057] At 404, the target identified in the model structure (e.g., a tumor) position. 鉴定目标结构可包括从模型、 描述目标结构的使用者输入、或其他参考来源确定或接收关于目标结构的信息。 Identification of the target structure may comprise determining or receiving information on the target structure from the model, the user inputs a description of the target structure, or other reference sources. 这种关于目标结构的信息可包括,例如,目标结构的形状、形成目标结构的一种或多种物质、和目标结构表面相对于附近解剖学通道的位置。 Such information about the structure of a target may include, for example, the shape of the target structure, form one or more species of the target structure, and the target structure relative to a position near the surface of the anatomical passageway.

[0058]在4〇6,接收关于介入器械操作能力的信息。 [0058] In 4〇6, receiving information about the operational capability interventional instrument. 接收以确定介入器械操作能力的信息可包括,例如,关于器械弯折能力如导管材料挠性和弹性的信息、经过导管管道的导管或工具的任何预成形的形状特征、导管或工具远端的转向性、和沿导管长度的曲度。 Receiving information interventional device to determine operational capabilities may include, for example, the ability to bend the instrument about the catheter material flexibility and elasticity information through any preformed shape feature catheter tube catheter or tool, the distal end of a catheter or tool steerability, and curvature along the length of the catheter. 介入器械的操作能力还可由介入器械的特征确定,如导管直径、工具直径、工具轴与导管轴的最大成角、工具可从导管伸出的最大长度、和导管远端提供与通道壁摩擦接触的任何锚定结构。 Interventional instrument handling capacity may also be determined by the characteristics of the interventional instrument, such as vessel diameter, the maximum diameter of the angled tool, the tool shaft and the catheter shaft, the maximum length of the tool may extend from the catheter, and the distal end of the catheter to provide frictional contact with the channel walls any anchoring structure. [0059] 在408,定位介入器械的设计布置位置。 [0059] At 408, the positioning arrangement positions of the interventional instrument design. 设计布置位置可被标记在多个通道的模型上。 Design layout position may be marked on the model of the plurality of channels. 设计布置位置可基于器械操作能力信息、目标结构信息、患者解剖学信息、或各类信息的组合来选择。 Design layout position may be selected based on the device capability information of the operation, the target structure information, patient anatomical information, or a combination of various types of information. 选择的布置位置可以处于解剖学通道中与目标结构最接近的点。 Arrangement may be in the anatomical position of the selected channel and the point closest to the target structure. 然而,在很多患者中,最接近点的布置位置可能不可能被介入器械远端到达,因为该器械在所选择的解剖学通道的尺寸和弹性限制内具有不足的弯折能力。 However, in many patients, the arrangement position of the closest point may not be reaching the distal end of the interventional instrument, as the instrument has insufficient ability to bend and the elastic limit in the size of the selected anatomical passageway. 较适当的布置位置可处于解剖学通道壁上介入器械相对于通道壁的啮入角在器械弯折能力范围内的点。 The arrangement may be more appropriate in the anatomical position of the interventional instrument with respect to the channel walls of the channel wall into engagement point angle in the bending capability of the instrument. 例如,如果介入器械具有几乎不允许或不允许弯折的僵硬远端,则适当的布置位置可处于目标结构附近的隆突。 For example, if the distal end of the interventional instrument having a rigid bent almost not or are not allowed, the appropriate placement of the keel may be in the vicinity of the target structure. 在隆突处,介入器械可在器械远端最小弯折的情况下以与通道壁约90 °的啮入角布置。 In the carina, a case where the distal end of the instrument at the interventional instrument may be disposed in a minimum bend channel wall and engages into an angle of approximately 90 °. 作为另一实例,穿行设计模块可选择布置位置,使得啮入角在约30°和90°之间。 As another example, design module selectively disposed walking position, such that the nip angle between about 30 ° and 90 °. 在选择布置位置时,设计系统还确认介入工具能够从导管延伸足够的距离,以到达目标结构,进行介入程序。 When choosing the arrangement position, the system design can be further confirmed interventional tool extending a sufficient distance from the conduit to reach the target structure, interventional procedures.

[0060]如述,可基于器械操作能力、目标结构、和患者解剖结构的分析来定位设计布置位置。 [0060] As described above, the operation capability of the target device may be based on structural analysis, the patient's anatomy and designed to locate the disposed position. 代替或结合系统评估,设计布置位置可由临床医生鉴定,并通信至穿行设计模块,以在模型中定位或标记临床医生鉴定的设计布置位置。 Instead of or in conjunction with system evaluation, design and layout of the location identified by the clinician, and a communication module designed to walk through, to locate or identify markers of clinical physicians in the model designed arrangement position. 当穿行设计模块接收临床医生鉴定的设计布置位置时,则模块可将其与系统鉴定的布置位置比较。 When the position receiver arranged crossed design clinical physician identification module design, the module may be compared with the arrangement position of the identification system. 如果临床医生鉴定的布置位置被反对(例如,“选择的活组织检查针长度不够从此布置位置到达目标。”),可发出视觉或听觉反馈提示。 If the arrangement is a position opposed to the clinician identification (e.g., "Select the biopsy needle is not long enough to reach the target position from this arrangement."), May issue a visual or audible feedback prompts.

[0061] 任选地,穿行设计模块鉴定多个可选布置位置。 [0061] Optionally, a plurality of design blocks identified walking alternative arrangement position. 可选的布置位置可被编码(例如, 在显示上用颜色编码),以提供关于对于布置介入器械以执行程序可选的布置位置的相对性能的信息。 Alternative arrangement position may be encoded (e.g., color coded on the display), to provide information about the relative performance of the interventional device is arranged to execute the program to the position of the alternative arrangement. 临床医生可选择可选布置位置中的一个作为设计布置位置。 Alternatively a clinician may elect to position arrangement is arranged as a design position. 可选地,可从可选布置位置选择多于一个设计布置位置,以使介入程序从不同途径进行。 Alternatively, more than one design may be arranged in a position selected from a position of an alternative arrangement to enable interventional procedure from different routes. 如果临床医生确定最初选择的布置位置并不适合,可选布置位置的选择还可在介入程序期间进行。 If the clinician to determine the arrangement of the initially selected location is not suitable, optionally select the location of the arrangement can also be carried out during the interventional procedure.

[0062] 为进一步精细化鉴定目标结构的步骤,可利用成像系统212中的一个或多个来收集在介入器械被布置于鉴定的布置位置或其一般附近后关于目标结构的位置的额外信息。 [0062] The identifying step further refine the target structure, the imaging system 212 may utilize one or more collected in the general vicinity of the interventional device or is arranged in the arrangement position identified additional information about the location of the target structure. 现参考图6,再次显示目标结构302和附近解剖学通道304的虚拟图像300。 Referring now to Figure 6, showing the vicinity of the target anatomical structure 302 and virtual image 300 channel 304 again. 挠性体309的远端先被定位在目标确认位置,如位置312。 The distal end of the flexible body 309 is first positioned at the target position confirmation, such as position 312. 图像拍摄探头226被操作以确定目标结构302是否相对于目标确认位置处于预期定位。 Image pickup probe 226 is operated to determine whether the target structure 302 relative to the target position is expected to confirm the positioning. 如果目标结构302没有被找到或没有处于预期定位,则可使挠性体和图像拍摄探头左右移动,直到定位到目标结构。 If the target structure 302 is not found or not in the intended position, you can move around the flexible body and the image capturing probe, target until the target structure. 当定位到目标结构时,将挠性体309或图像拍摄探头的远端位置记录在新位置322处。 When the positioning to the target structure, the position of the distal end of the flexible member 309 or captured image recorded at the new location of the probe 322. 然后穿行设计模块211更新目标结构302'的位置。 Design module 211 then updates the target walking structure 302 'position. 随着目标结构的新位置被鉴定,利用介入器械的操作能力信息鉴定修正的设计布置位置324。 With the new position of the target structure is identified using the identification information of the operating capability of the interventional instrument corrected design layout position 324. 例如,穿行设计模块可利用位置312和322之间的差异来将位置314更新至位置322,和目标结构302的位置更新至302 '。 For example, design module may walk through the use of the difference between position 312 and position 322 to position 314 to update 322, and target location 302 of the structure 302 to update '. 在一个实施方式中,图像拍摄探头利用一个或多个反射成像技术如超声波或0CT的传感器来精细化目标结构的位置。 In one embodiment, the image capturing probes using one or more reflective or imaging techniques such as ultrasound sensors to 0CT target structure fine position. 可选地,其他非成像传感器可用于鉴定目标结构的位置。 Alternatively, other non-imaging sensors may be used to identify the position of the target structure.

[0063] 图8是描述穿行设计模块用于修正介入器械的设计布置位置的方法450的流程图。 [0063] FIG 8 is a flowchart of a method for modifying the design module design layout position of the interventional instrument 450 described walking. 在452,在探头已在最初的设计布置位置或在目标确认位置操作后,从图像拍摄探头接收信息。 In 452, the probe is disposed in the initial design or a position after confirming the position of the operation target, receiving information from the image capturing probe. 在454,利用从图像拍摄探头接收的信息鉴定目标结构的修正位置。 In 454, the position information of the correction target structures identified from the captured image using the received probe. 在456,在多个通道的模型中鉴定修正后的设计布置位置。 In 456, the corrected model identified multiple channels designed arrangement position.

[0064] 可选的利用成像系统212鉴定目标结构的方法500在图9描述,并且在图10和11示例。 [0064] An alternative method to identify the target structure using the 212 imaging system 500 described in FIG. 9, and FIGS. 10 and 11 in the example. 方法500可进行以鉴定最初的介入布置位置,或可用于鉴定修正的布置位置,如下所述。 The method 500 may be arranged to identify the initial intervention position, or may be used to identify the position correction arrangement, as described below.

[0065] 在502,使导管在穿行系统的指导下穿行至通道位置如位置312或314,该穿行系统的指导包括例如视觉、EM或形状传感器信息。 [0065] At 502, walk through the catheter to a position such as position 312, or the channel 314 under the direction of walking through the system, the guidance system comprises, for example, walking through a visual, the EM sensor or shape information. 当导管已到达位置时可提供来自临床医生或介入器械的确认。 When the catheter has reached the position may provide an acknowledgment from the clinician or interventional instrument. 在504,将成像探头(例如,超声探头)插入通过导管,并且跟踪成像探头相对于部分导管(例如,导管末端)的运动。 At 504, the imaging probe (e.g., an ultrasound probe) is inserted through the catheter probe relative to the imaging and tracking portion of the catheter (e.g., the catheter tip) movement. 在一些实施方式中,在5〇2的穿行过程中也可使用相同成像探头(例如,相同超声探头)。 In some embodiments, the process 5〇2 walk through the same imaging probe can also be used (e.g., the same ultrasound probe). 可跟踪成像探头的运动,例如利用定位传感器如5或6 自由度EM传感器。 Imaging probe movement can be tracked, for example, by a positioning sensor such as a 5 or 6 DOF EM sensors. 可选地,可利用位于患者解剖结构外的插入式传感器如编码器跟踪该运动。 Alternatively, using a plug-in sensor is located outside the patient's anatomy encoder of the moving track. 可选地,可通过连接步进马达以控制成像探头的插入动作来跟踪该运动。 Alternatively, by connecting the stepper motor to control the operation of the imaging probe inserted into the moving track.

[0066]在5〇6,相对于导管确定成像探头的成像坐标系统的滚转角。 [0066] In 5〇6, roll angle determined relative to the catheter imaging coordinate system of the imaging probe. 例如,可利用轴向成像探头和导管(例如,关键系统)的滚转对齐要件来确定滚转角。 For example, with axial conduit and imaging probe (e.g., key system) to determine the rolling elements roll alignment angle. 可选地,可使用位于患者解剖结构外的滚转传感器。 Alternatively, use may be located outside the patient's anatomy roll sensor structure. 在再一可选方式中,可通过在成像探头记录的图像中观察具有己知的相对于导管的角度的一个或多个标记或其他要件来确定滚转角。 In a further alternative embodiment, it may have a known phase angle for a conduit or a plurality of markings or other elements to determine the roll angle of the probe was observed in the image recorded by the imaging. 例如,要件或标记可位于导管外周,并且具有与导管的反差(例如,超声反差)。 For example, the catheter may be labeled elements or the outer periphery, and has a contrast with the catheter (e.g., ultrasound contrast).

[0067]在5〇8,使导管和/或成像探头在解剖学通道周围移动,以在探头生成的图像中检测目标结构。 [0067] In 5〇8, the catheter and / or imaging probe is moved around the anatomical passageway to detect a target image structure in the probe generated. 在51〇,在通过成像探头检测到目标结构后,临床医生可利用处于指示器位置的指示装置在图像中鉴定目标结构。 In 51〇, after detecting the target structure by the imaging probe, the clinician may identify the target structure in the image using the position pointing device in the indicator. 可通过呼吸和/或心脏循环选通的扫描,来生成图像(例如,超声图像)。 By the respiratory and / or cardiac gated scan cycle, to generate an image (e.g., an ultrasound image). 可由二维扫描构建三维图像。 Construction of three-dimensional image by two-dimensional scanning.

[0068]在512,将指示器位置转换到导管坐标系统或患者坐标系统(此前已被定位至导管坐标系统)。 [0068] At 512, converted to a catheter location indicator coordinate system or the patient coordinate system (catheter has previously been positioned to the coordinate system). 在514,可利用指示器位置施加相对于在术前解剖学模型中鉴定的目标结构的位置的偏移。 At 514, the offset position of the target structure identified preoperative anatomical model is applied with respect to a pointer position. 基于该偏移计算修正的目标结构位置。 The offset correction calculation based on a target position of the structure. 然后可移除成像探头,并可将活组织检查工具或其他介入工具通过导管插入,以在修正位置处进行程序(例如,活组织检查)。 Imaging probe may then be removed, and the biopsy tools or other interventional instrument is inserted through a catheter, at a correction position for the program (e.g., a biopsy).

[0069]虽然己描述本公开的系统和方法用于连通的肺支气管,但其也适用于通过自然或外科产生的连通通道穿行和处理多种解剖学系统一一包括结肠、肠、肾、脑、心脏、循环系统、或类似系统——中的任一种中的其他组织。 [0069] While the system and method of the present disclosure has described bronchopulmonary for communication, but it is also applicable to a variety of communication channels and handling walking anatomical systems produced by natural or surgical-including colon, intestine, kidney, brain , heart, circulatory system, or similar systems - in other tissues in any one. 本公开的方法和实施方式也适于非介入型应用。 The methods of the present disclosure and embodiments are also suitable for non-invasive applications.

[0070]本发明的实施方式中的一个或多个要素可以软件实施以在计算机系统如控制系统116的处理器中执行。 [0070] One or more elements of embodiments of the present invention may be implemented in software executed on a computer system, a processor control system 116. 当以软件实施时,本发明实施方式的要素实质上是执行所需任务的代码节段。 When implemented in software, elements of the embodiment of the present invention are essentially the code to perform the necessary tasks segment. 程序或代码节段可通过传送介质或通信连接作为在载波中体现的计算机数据信号已被下载,并且可存储在处理器可读存储介质或装置中。 The program or code segments may be ligated as a computer data signal embodied in a carrier wave has been downloaded through communication or transmission medium and may be stored in a processor-readable storage medium or device. 处理器可读存储装置可包括任何可存储信息的介质,包括光介质、半导体介质、和磁介质。 The processor-readable medium may include any storage device may store information, including an optical media, semiconductor media, and magnetic media. 处理器可读存储装置实例包括电路;半导体装置、半导体存储装置、只读存储器(ROM)、闪存、可擦除可编程只读存储器(EPROM)、软盘、CD-ROM、光盘、硬盘、或其他存储装置,代码节段可通过计算机网络如Internet、Intranet 等下载。 Examples of processor-readable storage means comprises a circuit; a semiconductor device, a semiconductor memory device, a read only memory (ROM), a flash memory, an erasable programmable read only memory (EPROM), a floppy disk, CD-ROM, optical disk, hard disk, or other storage means, the code segments may be as Internet, intranet and the like downloaded via a computer network.

[0071]注意,展示的过程和显示可不固有地关联于任何具体计算机或其他设备。 [0071] Note that the process may not be displayed and the display inherently associated with any particular computer or other apparatus. 多种这些系统所需的结构将在权利要求中作为要素呈现。 Various structures required for these systems will be presented as an element in a claim. 另外,本发明的实施方式未参考任何具体编程语言描述。 Further, embodiments of the present invention is not described with reference to any particular programming language. 会理解多种编程语言可如本文描述用于实施本发明的教导。 It will be appreciated variety of programming languages ​​may be used as described herein to implement the teachings of the present invention.

[0072]虽然在附图中描述和显示了本发明的某些示例性实施方式,但要理解,这些实施方式只是示例性和而非限制宽泛的发明,并且本发明的实施方式不限于显示和描述的具体构造和安排,因为本领域技术人员可想到各种其他修改。 [0072] Although described and shown in certain exemplary embodiments of the present invention, in the drawings, it is to be understood that these embodiments are merely illustrative, and not to limit the broad invention, and embodiments of the present invention is not limited to the embodiment shown and DETAILED constructed and arranged as described, since one skilled in the art that various other modifications are conceivable.

Claims (37)

1.一种设计布置介入器械的程序的方法,所述方法通过处理系统进行,所述方法包括: 接收解剖学结构的模型,所述解剖学结构包括多个通道; 在所述模型中鉴定目标结构; 接收关于所述介入器械在所述多个通道内的操作能力的信息; 基于接收到的关于所述介入器械的操作能力的信息,鉴定定位所述介入器械的远端以对所述目标结构执行所述程序的多个任选布置位置和所述多个任选布置位置中的每个的相对性能;以及在显示系统上显示所述模型中的所述多个任选布置位置,其中通过使用提供关于所述多个任选布置位置中的每个对于布置所述介入器械以执行所述程序的相对性能的信息的编码来显示所述多个任选布置位置中的每个。 An interventional procedure instrument design arrangement, the method performed by the processing system, the method comprising: receiving a model of the anatomical structure, said anatomical structure comprises a plurality of channels; identifying a target in the model configuration; receiving information regarding the operational capabilities of the interventional device within the plurality of channels; a distal end of the interventional device based on information identifying positioning operation ability is received about the interventional instrument to the target execution of the program structure of a plurality of positions and said plurality optionally arrangement optionally arranged relative performance of each of the positions; and optionally displaying the plurality of positions arranged in the model on the display system, wherein by using the arrangement optionally provided on the plurality of positions for each of said interventional device is arranged to encode information on the relative performance of the execution of the program to display a plurality of positions each arranged optionally.
2. 根据权利要求1所述的方法,其中鉴定所述多个任选布置位置包括接收代表所述介入器械的一个或多个特征的数据,所述一个或多个特征包括工具布置长度。 2. The method according to claim 1, wherein identifying the plurality of positions arranged optionally comprises receiving data representative of the interventional device or a plurality of features, said features comprising one or more tools arranged length.
3. 根据权利要求1所述的方法,其中鉴定所述多个任选布置位置包括接收代表所述介入器械的一个或多个特征的数据,所述一个或多个特征包括所述介入器械的弯折能力。 3. The method according to claim 1, wherein identifying the plurality of positions arranged optionally comprises receiving data representative of one or more characteristics of the interventional instrument, said one or more characteristics of the interventional instrument comprising bending ability.
4. 根据权利要求1所述的方法,其中鉴定所述多个任选布置位置包括接收代表所述介入器械的一个或多个特征的数据,并且其中所述介入器械包括导管主体和介入工具,所述一个或多个特征包括所述介入工具相对于所述导管主体的运动特征。 4. The method according to claim 1, wherein said identifying comprises receiving a plurality of positions arranged optionally instrument represents one or more features of the data involved, and wherein the interventional device comprises a catheter body and interventional tools, wherein the one or more motion feature comprises the interventional tools relative to the catheter body.
5. 根据权利要求1所述的方法,其中鉴定所述多个任选布置位置包括接收代表所述多个通道的特征的数据。 5. The method according to claim 1, wherein identifying the plurality of positions arranged optionally includes receiving data representative of the characteristic of the plurality of channels.
6. 根据权利要求5所述的方法,其中所述多个通道的特征包括与所述目标结构最接近的多个通道的尺寸。 6. The method according to claim 5, wherein said plurality of channels comprises the features closest to the target size of the structure of a plurality of channels.
7. 根据权利要求5所述的方法,其中所述多个通道的特征包括所述多个通道中的两个之间的隆突的位置。 7. The method as claimed in claim 5, wherein the location feature comprises a plurality of channels between the keel of the two of the plurality of channels.
8. 根据权利要求5所述的方法,其中所述多个通道的特征包括所述多个通道的弹性。 8. The feature of the method according to claim 5, wherein said plurality of channels comprises a plurality of resilient channels.
9. 根据权利要求1所述的方法,其中鉴定所述多个任选布置位置包括接收代表所述目标结构的特征的数据。 9. The method according to claim 1, wherein identifying the plurality of positions arranged optionally includes receiving data representative of the characteristics of the target structure.
10. 根据权利要求9所述的方法,其中所述目标结构的特征包括钙化位置。 10. The method according to claim 9, wherein wherein said target structure comprises position calcification.
11. 根据权利要求1所述的方法,进一步包括通过从所述多个任选布置位置中鉴定在所述多个通道中的一个中的初步布置位置,和基于指示所述目标结构的修正位置的传感器数据的接收将所述初步布置位置修正为所述设计布置位置,而从所述多个任选布置位置中鉴定设计布置位置。 11. The method according to claim 1, further comprising by the plurality of the preliminary arranged optionally from a location identified in the arrangement position of the plurality of channels, and correcting the target position indication Structure receiving the sensor data is corrected to the initial arrangement positions design layout position, and optionally from the plurality of positions arranged in the arrangement position of the identification design.
12. 根据权利要求11所述的方法,其中所述传感器数据包括代表所述目标结构相对于所述介入器械的远端的位置的超声波传感器数据。 12. The method according to claim 11, wherein the sensor data comprises representative of the target structure relative to the ultrasonic sensor data of the interventional instrument distal end position. _ _
13. 根据权利要求11所述的方法,其中所述传感器数据包括代表所述目标结构相对于所述介入器械的远端的位置的OCT传感器数据。 13. The method according to claim 11, wherein the sensor data comprises representative of the target structure relative to the sensor data OCT interventional instrument distal end position.
14. 根据权利要求1所述的方法,其中用于所述多个任选布置位置中的对应的任选布置位置的所述编码是指示所述对应的任选布置位置的相对性能的颜色。 14. The method according to claim 1, wherein a plurality of said encoding optionally the optional arrangement position corresponding to the arrangement position is optional arrangement position indicating the relative performance of the color corresponding to.
15. 根据权利要求1所述的方法,其中所述程序是活组织检查程序。 15. The method according to claim 1, wherein said program is a biopsy procedure.
16. 根据权利要求1所述的方法,进一步包括通过接收从所述多个任选布置位置中选择的临床医生鉴定的布置位置,从所述多个任选布置位置中鉴定设计布置位置。 16. The method of claim 1, further comprising receiving from the plurality optionally through position disposed clinician identification arrangement position selected optionally from the plurality of positions arranged in the arrangement position of the identification design.
17. 根据权利要求16所述的方法,进一步包括提供警报,指示所述临床医生鉴定的布置位置被反对。 17. The method of claim 16, further comprising providing an alarm, indicating that the identification of clinical doctors disposed opposed positions.
18. 根据权利要求16所述的方法,其中在所述设计布置位置处所述介入器械远端和通道壁之间的啮入角在30和90度之间。 18. The method according to claim 16, wherein said design is arranged at a position of the interventional instrument engagement between the distal end and into the channel wall angle of between 30 and 90 degrees.
19. 一种设计布置介入器械的程序的系统,所述系统包括: _ 非临时性计算机可读介质,包含用于设计布置介入器械的程序的计算机可执行指令, 所述计算机可执行指令包括接收解剖学结构的模型的指令,所述解剖学结构包括多个通道; 在所述模型中鉴定目标结构的指令; 接收关于所述介入器械在所述多个通道中的操作能力的信息的指令;和^ 基于接收到的关于所述介入器械的操作能力的信息鉴定定位所述介入器械的远端以对目标结构执行所述程序的多个任选布置位置和所述多个任选布置位置中的每个的相对性能的指令;和在显示系统上显示所述模型中的所述多个任选布置位置的指令,其中通过使用提供关于所述多个任选布置位置中的每个对于布置所述介入器械以执行所述程序的相对性能的信息的编码来显示所述多个任选布置位置中的每个。 19. A system for interventional instrument design layout program, the system comprising: _ a non-transitory computer-readable medium containing a computer program for designing arrangement of the interventional instrument-executable instructions, the computer executable instructions comprising receiving command model anatomical structure, said anatomical structure comprises a plurality of channels; instruction target structures identified in the model; receiving instruction information regarding operational capabilities of the interventional device within the plurality of channels; ^ and a distal end of the interventional device identification information based on the received operational capability positioned with respect to the interventional instrument to a plurality of target positions arranged optionally execution of the program structure and said plurality of positions arranged optionally instructions relative performance of each; and the plurality of instructions is optionally disposed in a position of the model is displayed on the display system in which by using a plurality of optionally providing each with respect to the arrangement positions arranged for the interventional device to encode information on the relative performance of the execution of the program to display a plurality of positions each arranged optionally.
20. 根据权利要求19所述的系统,进一步包括所述介入器械。 20. The system according to claim 19, further comprising the interventional instrument.
21. 根据权利要求19所述的系统,其中鉴定所述多个任选布置位置包括接收代表所述介入器械的一个或多个特征的数据,所述一个或多个特征包括工具布置长度。 21. The system according to claim 19, wherein identifying the plurality of positions arranged optionally includes receiving data representative of the interventional device or a plurality of features, said features comprising one or more tools arranged length.
22. 根据权利要求19所述的系统,其中鉴定所述多个任选布置位置包括接收代表所述介入器械的一个或多个特征的数据,所述一个或多个特征包括所述介入器械的弯折能力。 22. The system according to claim 19, wherein identifying the plurality of positions arranged optionally comprises receiving data representative of one or more characteristics of the interventional instrument, said one or more characteristics of the interventional instrument comprising bending ability.
23. 根据权利要求19所述的系统,其中鉴定所述多个任选布置位置包括接收代表所述介入器械的一个或多个特征的数据,并且其中所述介入器械包括导管主体和介入工具,所述一个或多个特征包括所述介入工具相对于所述导管主体的运动特征。 23. The system according to claim 19, wherein identifying the plurality of positions arranged optionally includes receiving data representative of one or more features of the instrument of the intervention, and wherein the interventional device comprises a catheter body and interventional tools, wherein the one or more motion feature comprises the interventional tools relative to the catheter body.
24. 根据权利要求19所述的系统,其中鉴定所述多个任选布置位置包括接收代表所述多个通道的特征的数据。 24. The system according to claim 19, wherein identifying the plurality of positions arranged optionally includes receiving data representative of the characteristic of the plurality of channels. _ _
25. 根据权利要求24所述的系统,其中所述多个通道的特征包括与所述目标结构最接近的多个通道的尺寸。 25. The system according to claim 24, wherein said plurality of channels comprises the features closest to the target size of the structure of a plurality of channels.
26. 根据权利要求24所述的系统,其中所述多个通道的特征包括所述多个通道中的两个之间的隆突的位置。 26. The system according to claim 24, wherein said plurality of channels includes a position wherein the keel between two of said plurality of channels.
27. 根据权利要求24所述的系统,其中所述多个通道的特征包括所述多个通道的弹性。 27. The system according to claim 24, wherein said plurality of channels of the elastic feature comprises a plurality of channels. 2S.根据权利要求19所述的系统,其中鉴定所述多个任选布置位置包括接收代表所述目标结构的特征的数据。 2S. The system according to claim 19, wherein identifying the plurality of positions arranged optionally includes receiving data representative of the characteristics of the target structure.
29.根据权利要求19所述的系统,其中所述目标结构的特征包括钙化位置。 29. The system according to claim 19, wherein wherein said target structure comprises position calcification.
30.根据权利要求19所述的系统,进一步包括通过从所述多个任选布置位置中鉴定在所述多个通道中的一个中的初步布置位置,和基于指示所述目标结构的修正位置的传感器数据的接收将所述初步布置位置修正为所述设计布置位置,而从所述多个任选布置位置中鉴定设计布置位置。 30. The system according to claim 19, optionally further comprising by the plurality of initial arrangement position from a position disposed in said plurality of channels identified in, and correcting the target position indication Structure receiving the sensor data is corrected to the initial arrangement positions design layout position, and optionally from the plurality of positions arranged in the arrangement position of the identification design.
31. 根据权利要求30所述的系统,其中所述传感器数据包括代表所述目标结构相对于所述介入器械的远端的位置的超声波传感器数据。 31. The system according to claim 30, wherein the sensor data comprises representative of the target structure relative to the ultrasonic sensor position data of the distal end of the interventional instrument. _ _
32. 根据权利要求30所述的系统,其中所述传感器数据包括代表所述目标结构相对于所述介入器械的远端的位置的0CT传感器数据。 32. The system according to claim 30, wherein the sensor data comprises representative of the target structure relative to the sensor data 0CT interventional instrument distal end position.
33. 根据权利要求30所述的系统,其中用于所述多个任选布置位置中的对应的任选布置位置的所述编码是指示所述对应的任选布置位置的相对性能的颜色。 33. The system according to claim 30, wherein a plurality of said encoding optionally the optional arrangement position corresponding to the arrangement position is optional arrangement position indicating the relative performance of the color corresponding to.
34. 根据权利要求19所述的系统,其中所述程序是活组织检查程序。 34. The system according to claim 19, wherein said program is a biopsy procedure.
35. 根据权利要求19所述的系统,进一步包括通过接收从所述多个任选布置位置中选择的临床医生鉴定的布置位置,从所述多个任选布置位置中鉴定设计布置位置。 35. The system according to claim 19, further comprising receiving from the plurality optionally through position disposed clinician identification arrangement position selected optionally from the plurality of positions arranged in the arrangement position of the identification design.
36. 根据权利要求35所述的系统,进一步包括提供警报的指令,所述警报指示所述临床医生鉴定的布置位置被反对。 36. The system according to claim 35, further comprising instructions to provide an alarm, indicating the arrangement position of the alarm is identified against the clinician.
37. 根据权利要求35所述的系统,其中在所述设计布置位置处所述介入器械的远端和通道壁之间的啮入角在30和90度之间。 37. The system according to claim 35, wherein said design at an arrangement position of the interventional engagement between the distal end and into the instrument channel wall angle of between 30 and 90 degrees.
38. —种设计利用从导管布置的介入工具的介入程序的方法,所述方法通过处理系统进行,所述方法包括: 接收解剖学结构的模型,所述解剖学结构包括多个通道; 在所述模型中鉴定目标结构; 接收关于所述介入工具相对于所述导管的远端的延伸长度的信息; 基于接收到的关于所述介入工具的延伸长度的信息,鉴定用于定位所述导管的远端以对所述目标结构执行所述介入程序的多个任选布置位置和所述多个任选布置位置中的每个的相对性能;和在显示系统上显示所述模型中的所述多个任选布置位置,其中通过使用提供关于所述多个任选布置位置中的每个对于布置所述介入器械以执行所述程序的相对性能的信息的编码来显示所述多个任选布置位置中的每个。 38. - interventional procedure kinds of design using the catheter arrangement interventional tool, the method performed by the processing system, the method comprising: receiving a model of the anatomical structure, said anatomical structure comprises a plurality of channels; in the identifying said model of the target structure; interventional tool with respect to the received information with respect to the extended length of the distal end of the catheter; based on the information about the extended length of the interventional tool received, identifying for positioning of the catheter optionally a plurality of positions arranged in the distal end of an interventional procedure is performed for the plurality of the target structure and optionally the relative performance of each of the arrangement positions; and displaying the model on the display system optionally a plurality of arrangement positions, wherein by using a plurality of optionally provide information about the arrangement position of each of said interventional device is arranged to encode information corresponding to the performance of execution of the program to display the plurality optionally each arrangement position.
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